Articles

Background and importance: Sacral fractures often lead to injuries of the lumbosacral nerve, which will cause tremendous damage to the patient’s motor and sensory functions. At present, the most commonly used surgical method is the posterior median approach, the extent and degree of neurolysis are often insufficient, so the effect of neurolysis is not well, and the functional recovery of patients after operation is often incomplete.Clinical presentation: The patient was a 17-year-old male who accidentally fell from a height and landed on his hip. The main clinical feature of the patient was persistent radiating pain in the right lower extremity with right lower limb sensorimotor disorder. The results of the X-ray examination indicated a sacral fracture and a right pubic fracture. After the injury, the patient underwent pelvic internal fixation surgery within 72 hours. Then 6 months after the surgery, there was no significant improvement in right lower limb function, and the patient came to our hospital seeking treatment. Considering the severe lumbosacral plexus injury and the history of surgery, we performed an “Anterior surgery approach combined with posterior approach for lumbosacral neurolysis” for the patient, postoperative radiation pain disappeared completely, and there were significant improvements in the muscle strength of some muscles and sensory function.Conclusion: The relaxation of the lumbosacral plexus is usually performed through a single surgical approach, which has great limitations in the effect of relaxation. Here, we demonstrate a case in which posterior lumbar incision and anterior laparoscopic lumbosacral plexus neurolysis can benefit the patient, the lumbosacral nerve was released to a great extent. We aim to bring this case to the attention of our worldwide neurosurgical colleagues and share our surgical approach to assist those who may encounter this case in the future.

Objective: This research was conducted to determine medication compliance and factors affecting compliance with type 2 diabetes patients in public hospitals.Method: This research is a descriptive type of research, which is one of the Quantitative research types. There was no sample selection in the study, and the study was conducted with 100 patients who met the Inclusion criteria. Research data was collected between December 2022 and June 2023. Results: The patients ' compliance with the medication appears to be at a moderate level. The difference in the Medication Compliance Reporting scale mean scores difference According to the patients' genders, whom they live with, marital status, diabetes duration, treatment method, and daily insulin application the status is not statistically significant. Conclusion: In this study, it was determined that the medication compliance of elderly type 2 diabetic patients was at a moderate level. It is recommended That nurses organize awareness training on the factors affecting medication compliance of elderly type 2 diabetic patients and That the research be conducted​ with a larger sample group.

This study evaluates the effects of two months of regular snoezelen therapy on anger-hostility (AH), assessing both psychological and physiological indicators before and after the intervention. Using the Profile of Mood States (POMS-2), the research measured changes in anger-hostility levels and stress responses, comparing pre- and post-intervention data. At baseline, participants exhibited relatively high levels of anger-hostility, with psychological scores averaging 40.14 (± 2.46) and physiological scores averaging 42.25 (± 2.71), indicating significant irritability, aggression, and elevated stress responses. After two months of multisensory stimulation in a snoezelen room, participants’ psychological scores decreased to 37.40 (± 2.26) and physiological scores to 39.50 (± 2.01), suggesting improvements in mood and physiological stress. The statistical analysis yielded a p - value of 0.047, indicating that the reductions were significant. These findings suggest that snoezelen therapy can be effective in reducing anger-hostility and associated physiological stress, offering a promising intervention for emotional regulation and stress management.

Ventricular Septal Defect, also known as VSD is a rare and life-threatening complication associated with MI. Therefore, it should be immediately diagnosed and treated. Transcatheter closure of the ventricular septal defect is a new alternative treatment approach compared to surgery. In this case, we presented a patient with post-infarct basal ventricular septal defect whose ventricular septal defect was closed using an atrial septal defect closure device. The ability to successfully close such a large defect via catheter is promising for the treatment of patients with VSD.

The article presents data from recent publications and own data on screening studies with interpretation of chest radiographs using artificial intelligence CAD (Computer-Assisted Diagnosis), which, according to WHO recommendations, provides more accurate clinical thresholds for deciding who needs to take a sputum test. Another aspect of the WHO recommendations is the cost-effectiveness of CAD as a tool for triaging patients with tuberculosis symptoms in low-income countries with a high incidence of tuberculosis. Compared with smear microscopy and GeneXpert, without preliminary sorting, the use of mobile digital X-ray machines equipped with a CAD tool reduces costs, allowing sorting of individuals suspected of having tuberculosis for testing on GeneXpert, while reducing the time to start tuberculosis treatment.Thus, conducting a study using portable X-ray machines using a CAD program is a low-cost and easy-to-implement method, does not require large funds, does not require separate rooms, is highly effective, has good image quality, allows you to quickly clarify individuals suspected of having tuberculosis, differentiating it from other pathological changes in the lungs.Our experience shows that machine analysis of chest computed tomography data, due to the higher resolution capabilities of the method and the absence of fundamental disadvantages of radiography, including the effect of shadow summation, the presence of “blind” zones, etc., is finding increasing application in both diagnostics and screening of respiratory diseases. Our use of this tool allowed us to identify additional new cases of phthisio-onco-pulmonary diseases in field conditions.

Background: Clinical education is an important component of physiotherapy education programs. It provides insights to the students in the fields of physiotherapy practice, develops leadership, and enhances their clinical skills in patient assessment, examination, diagnosis, treatment, planning, and intervention selection. The dimension of physiotherapy education is in the developing phase in Nepal. For further growth, the experience and the perception of the students are very important. Through this, the facilitators and barriers in physiotherapy clinical education need to be recognized. Therefore, this study aimed to explore the facilitators and barriers in physiotherapy clinical education in Nepal from a student’s perspective.Objectives: The main objective of this study was to identify the perception of physiotherapy undergraduate students about their clinical education and to find out the facilitators and barriers in clinical education.Methods: A qualitative research using focused group discussion was conducted. Ethical considerations were taken from respective departments and IRC approval was taken. BPT 3rd year, 4th year, and intern students of KUSMS were called to participate in the study. After the consent from the participants, focus groups of 6 participants (2 participants from each 3rd year, 4th year, and intern) were formed. In five FGDs, data saturation was observed and no further FGDs were conducted. FGDs were collected with audio tape recordings. The data were transcribed verbatim and translated into the English language. Then data coding was done and themes and sub-themes were generated from the codes.Results: Through the transcribed and translated data, seven themes were generated which were clinical education, student expectation, student attitude and behavior, roles and responsibilities of clinical educators, exposure, resources, and miscellaneous. These headings explained the perception of facilitators and barriers.Conclusion: The facilitators and barriers to physiotherapy clinical education were identified through student’s perspectives. These findings should be considered while preparing the guiding document for clinical education to enhance the quality of education.

Granulomatous diseases can cause hypercalcemia due to elevated 1,25-dihydroxyvitamin D through the production of 1-α hydroxylase by macrophages in the granulomas. Tophaceous gout is not considered to cause this picture. However, there are a few case reports of this occurrence in tophaceous gout, as well as the description of intense 1-α hydroxylase activity in granulomas of tophi in gout patients. We review this literature, and we report a well-documented case of hypercalcemia with elevated serum 1,25 dihydroxyvitamin D in a patient with extensive tophaceous gout and tophi loaded with granulomas. An extensive work-up ruled out other causes of hypercalcemia and granulomatous diseases. Prednisone corrected the chemical abnormalities. Diffuse tophaceous gout should be considered a rare cause of hypercalcemia due to excessive 1,25 dihydroxy vitamin D.

The background of my paper is that magnetization dynamics is a very important subject of basic and technological research. The purpose of the paper is to review various theories of magnetization dynamics. There are many important technological applications of magnetization dynamics.

Congenital Dyserythropoietic Anaemia (CDA) is a rare genetic disorder that affects the maturation of red blood cells. The disorder is classified into different types, with a prevalence ranging from 1 in 100,000 to 1 in 1,000,000 individuals. Treatment strategies are designed with the primary focus on symptom management, the prevention and treatment of complications, and the underlying disease pathophysiology. The advent of bone marrow transplantation, gene therapy, and targeted therapies has considerably expanded the scope for therapeutic intervention in CDAs. Supportive care, including blood transfusions and iron chelation therapy, has demonstrated efficacy in managing iron overload and improving overall survival rates. The potential of gene therapy, targeted therapies, and hematopoietic growth factors in the treatment of CDA is currently being investigated. Further research and clinical trials are required to develop more effective and personalized therapeutic interventions.

In many sectors, ranging from sports and military operations to professional settings (notably cognitive enhancement); human performance augmentation has been an enduring ambition. The idea behind this movement, known as human enhancement, has evolved over time from simple means of training to the improvement or augmentation of physical ability through recent developments in fields such as pharmaceuticals and implantable devices that can enhance natural abilities. They span from pharmaceutical agents to wearable technologies used for sophisticated self-experimentation, which offer promise but also present ethical, health, and societal risks Performance-Enhancing Drugs are used to enhance the performance of humans in one way or another as a basic idea. The categories of Performance Enhancing Drugs (PEDs) included are Stimulants: Stimulant drugs, including amphetamines and caffeine (in the form of coffee) have been used for thousands of endeavours and physical stamina for decades. There have been many sources of controversy in the sporting world due to use or misuse and side-effectual restrictions. The release of neurotransmitters such as dopamine and allowing muscles to grow big, and fast. Nevertheless, the consumption of anabolic steroids is strictly controlled because it has side effects and complications such as liver damage, hormonal imbalances, and greater aggression. Erythropoietin EPO is a hormone that produces red blood cells, and increased oxygen delivery to muscle. EPO Athletes and even more notably endurance athletes (such as cyclists) have a storied history of abusing this performance-enhancing agent to build stamina. However, the misuse of this drug can be very hazardous, as it causes complications such as blood clotting and heart issues.